DOCSLIB.ORG

When Avoidant/Restrictive Food Intake Disorder Becomes Life Threatening: a Case Report of an Adult Male Patient

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
When Avoidant/Restrictive Food Intake Disorder Becomes Life Threatening: a Case Report of an Adult Male Patient Avoidant/Restrictive Food Intake Disorder When Avoidant/Restrictive Food Intake Disorder Becomes Life Threatening: A Case Report of an Adult Male Patient Susan L. Bennett, PhD, CEDS; Thomas M. Dunn, PhD; Gillian T. Lashen, PsyD; Jacqueline V. Grant, LCSW; Jennifer L. Gaudiani, MD, CEDS; Philip S. Mehler, MD, FACP, FAED, CEDS* Introduction texture) of food are believed to mediate willing- 5 Avoidant/Restrictive Food Intake Disorder (ARFID) is ness to eat a non-familiar item. While most of the a recent addition to the fifth edition of the Diagnos- research in this area has been done with children, disgust reactions in adults regarding food has also tic and Statistical Manual of the American Psychiat- 6 ric Association (DSM-5).1 The primary concerns in been established. Presumably, for some individuals, ARFID are that the patient is not consuming enough particular sensory properties of food signal a warn- ing about ingestion, thereby leading to restricted nutrients necessary to meet daily nutritional de- 7 mands and that food restriction is causing impair- eating. Finally, DSM-5 criteria for ARFID note that ment in functioning.2 These concerns are explicitly some people may restrict food intake because of a conditioned negative response, or in anticipation of addressed with one part of the DSM-5 criteria for 1 ARFID: “the persistent failure to meet nutritional an aversive experience while eating. This has been needs resulting in weight loss (or inability to gain explored in the literature and described sometimes choking phobia phagophobia weight in children), malnutrition, reliance on enteral as a , or . Such a fear is typically associated with weight loss and social dys- feeding or dietary supplements, and/or substantial 8,9 dysfunction in everyday functioning.”1 However, un- function. Anticipatory anxiety regarding the aver- like anorexia nervosa (AN), those with ARFID do not sive act of vomiting may also result in disordered emetophobia have associated issues with body shape or weight.3 eating. Fear of vomiting, or , has been Instead, there is an associated disturbance in eat- associated with reduced quantity of food eaten (to ing that is attributed to 3 different features that lessen the amount of vomit) and food restriction, comprise the second part of the DSM-5 criteria for either by refusing to eat food prepared by another ARFID: (1) disinterest in eating, (2) aversion to par- person, or becoming highly selective about eating only food items that are perceived as having a low ticular sensory properties of food, or (3) excessive 10,11 anxiety about an aversive event associated with eat- chance of inducing emesis. ing.1 These features will be discussed briefly below. In summary, there are 2 inclusion criteria for ARFID: Disinterest in food or eating is often described as one of the aforementioned 3 eating or feeding dis- selective eating (among other terms) and has been turbances and persistent failure to meet nutritional typically associated with unusually narrow dietary needs. Additionally, there are 3 exclusion criteria to preferences and marked reluctance to try new which the eating or feeding disturbance cannot be types of food, lasting more than 2 years.4 Aversion attributed: it cannot be diagnosed (1) in the setting to sensory properties of food has also been identi- of food scarcity or a culturally-sanctioned practice, fied as a feature of ARFID.1 Perceptions about the (2) during a course of AN or bulimia nervosa (BN), negative sensory properties (particularly taste and nor (3) with a disturbance in how body weight or *Author Affiliation: Department of Psychiatry, University of Colorado School of Medicine, Aurora, CO (Dr Bennett); ACUTE Center for Eating Disor- ders, Denver Health, Denver, CO (Drs Bennett, Lashen, Gaudiani, and Mehler, and Ms Grant); School of Psychological Sciences, University of Northern Colorado, Greeley, CO (Dr Dunn); Behavioral Health Services, Denver Health, Denver, CO (Dr Dunn); Department of Medicine, University of Colorado School of Medicine, Aurora, CO (Drs Gaudiani and Mehler); and Eating Recovery Center, Denver, CO (Dr Mehler). Drs Bennett and Gaudiani are now with the Gaudiani Clinic, Denver, CO. *Corresponding Author: Susan L. Bennett, PhD, CEDS, Gaudiani Clinic, 4700 Hale Parkway, Suite 380, Denver, CO 80220 (drbennett@gaudianiclinic. com). 18 Bennett, Dunn, Lashen, Grant, Gaudiani, Mehler shape is perceived; moreover the symptoms cannot ports each patient 1:1, and psychiatric consultation as be better explained by a co-occurring medical condi- needed. 1 tion or another mental disorder. Although ARFID Mr X was estimated to be only 68% of his IBW at pre- unites conditions that are associated with restricted sentation and was found to have bradycardia, hypo- food intake (and not associated with other eating tension, leukopenia, anemia, and profound hypotes- disorders), the particular etiology of disturbed eating tosteronism as a result of his severe malnutrition. can be quite varied. Patients who meet criteria for ARFID are a highly heterogeneous group, complicating Mr X first came to medical attention 1 year prior to research and treatment strategies. this admission, when he developed abdominal pain, rectal urgency, and was found to have excessive stool Only codified in the DSM since 2013, research on the and obstipation. He underwent exploratory lapa- 2,12 treatment of ARFID is virtually non-existent. There rotomy with no additional findings. The symptoms is also a paucity of research regarding those with resolved following extensive chemical and mechanical ARFID who are severely medically compromised. In bowel disimpaction. A recurrence of symptoms fol- this article, we present such a case—a young adult lowed some months later, and Mr X was admitted to male with severe malnutrition secondary to food a hospital with severe obstipation and fecal vomiting. restriction not related to fear of weight gain. Our aim He was subsequently diagnosed with Celiac disease, is to provide guidance for diagnostic assessment and confirmed by both biopsy on upper endoscopy and psychotherapeutic intervention for medically unstable antibody testing. Celiac disease is prevalent in his patients with ARFID. family. He reported seeking treatment due to a 30-pound Case Report weight loss over the past year. This weight loss was In February of 2015, a markedly emaciated 18-year- attributed to the patient restricting intake and follow- old male, Mr X, presented to the ACUTE Center for ing a strict gluten-free diet, as well as avoiding red Eating Disorders (ACUTE) at Denver Health Medical meat, dairy products, and processed foods due to fear Center for treatment of severe malnutrition. ACUTE is of abdominal pain. Mr X also denied eating junk food. a 15-bed medical stabilization unit for medically com- Additionally, he frequently played soccer and went promised adults with eating disorders who require snowboarding. medical stabilization prior to transfer to traditional With his family’s support, he agreed to enter an eat- mental-health focused inpatient or residential eating ing disorder program. However, out of concern for his disorder programs across the United States. Indica- degree of medical instability, the program referred tions for admission typically include patients with an- him initially to ACUTE to begin weight restoration and orexia nervosa restricting subtype (AN-R) whose body medical stabilization. weight is less than 70% of ideal body weight (IBW); patients with anorexia nervosa binge-purge subtype Physical Findings (AN-BP) whose body weight is less than 75% of IBW but who have concomitant severe electrolyte abnor- Presenting weight, IBW, body mass index (BMI), vital malities or prior inability to cease purging behaviors signs, noteworthy laboratory studies, and electrocar- because of severe edema formation; patients with diogram interpretation are given in Table 1. ARFID who meet weight/medical complexity criteria Diagnostic Assessment as described above; and patients with a serious eating disorder and another concurrent medical diagnosis Following an initial diagnostic interview and as- which makes stabilization in a specialized medical set- sessment, Mr X agreed he was underweight and ting preferable and safer. The ACUTE team follows a understood the seriousness of his malnutrition. He multidisciplinary approach to patient care. The clinical explained that his restrictive diet was in service of team includes an attending internal medicine physi- avoiding abdominal pain and/or constipation, as well cian, clinical psychologist, registered dietitian, social as optimizing his athletic performance. He did not worker, physical therapist, occupational therapist, present as being preoccupied with his appearance or registered nurse, certified nursing assistant who sup- driven for thinness. No fear of gaining weight was not- 19 Avoidant/Restrictive Food Intake Disorder ed. He denied symptoms associated with depression, hospitalization. Mr X had a close relationship with his anxiety or other psychiatric disturbance, and there family, and he was encouraged to utilize those rela- was no history of substance use disorder. tionships for support. Eating disorder type was determined collaboratively During Mr X’s hospitalization, standard ACUTE medical between the clinical psychologist and attending physi- protocols were employed, included 24-hour telem- cian, based on the patient’s clinical presentation and etry, labs, blood glucose checks every 4 hours, warm- the DSM-5 inclusion and exclusion criteria.
Load more

Recommended publications
  • Emetophobia in Youth: How Comprehensive Conceptualization Guides Effective Treatment
    Anxiety and Depression Journal Open Access Short Review Emetophobia in Youth: How Comprehensive Conceptualization Guides Effective Treatment Mary K. Plisco * Department of Anxiety and Depression, Richmont Graduate University, USA A R T I C L E I N F O A B S T R A C T Article history: Received: 19 July 2018 Emetophobia consists of an anxiety disorder characterized by the marked Accepted: 22 August 2018 Published: 25 August 2018 fear about specific objects or situations that may lead to vomiting. Keywords: Epidemiological studies have reported prevalence rates ranging from 0.1% to Fear of vomiting; Developmental; 8%, and youth who are untreated experience a chronic and fluctuating course Conceptualization; Treatment; Family characterized by significant impairments in functioning, including increased family conflict, disruptions to academic participation, and interference with Copyright: © 2018 Plisco MK et al., social interactions. Additionally, avoidance behaviors associated with Anxiety Depress J This is an open access article distributed emetophobia can lead to deficits in nutritional intake that may negatively under the Creative Commons Attribution License, which permits unrestricted use, affect child and adolescent physical development. It is important that clinicians distribution, and reproduction in any medium, provided the original work is are aware of the multiple factors that play a role in the development and properly cited. maintenance of the problem. Incorporating developmental, motivational, and Citation this article: Plisco MK. family-based theoretical frameworks into the established cognitive behavioral Emetophobia in Youth: How Comprehensive Conceptualization Guides Effective model for treatment of emetophobia will enhance treatment outcome. Treatment. Anxiety Depress J. 2018; 2(1):115.
    [Show full text]
  • List of Phobias: Beaten by a Rod Or Instrument of Punishment, Or of # Being Severely Criticized — Rhabdophobia
    Beards — Pogonophobia. List of Phobias: Beaten by a rod or instrument of punishment, or of # being severely criticized — Rhabdophobia. Beautiful women — Caligynephobia. 13, number — Triskadekaphobia. Beds or going to bed — Clinophobia. 8, number — Octophobia. Bees — Apiphobia or Melissophobia. Bicycles — Cyclophobia. A Birds — Ornithophobia. Abuse, sexual — Contreltophobia. Black — Melanophobia. Accidents — Dystychiphobia. Blindness in a visual field — Scotomaphobia. Air — Anemophobia. Blood — Hemophobia, Hemaphobia or Air swallowing — Aerophobia. Hematophobia. Airborne noxious substances — Aerophobia. Blushing or the color red — Erythrophobia, Airsickness — Aeronausiphobia. Erytophobia or Ereuthophobia. Alcohol — Methyphobia or Potophobia. Body odors — Osmophobia or Osphresiophobia. Alone, being — Autophobia or Monophobia. Body, things to the left side of the body — Alone, being or solitude — Isolophobia. Levophobia. Amnesia — Amnesiphobia. Body, things to the right side of the body — Anger — Angrophobia or Cholerophobia. Dextrophobia. Angina — Anginophobia. Bogeyman or bogies — Bogyphobia. Animals — Zoophobia. Bolsheviks — Bolshephobia. Animals, skins of or fur — Doraphobia. Books — Bibliophobia. Animals, wild — Agrizoophobia. Bound or tied up — Merinthophobia. Ants — Myrmecophobia. Bowel movements, painful — Defecaloesiophobia. Anything new — Neophobia. Brain disease — Meningitophobia. Asymmetrical things — Asymmetriphobia Bridges or of crossing them — Gephyrophobia. Atomic Explosions — Atomosophobia. Buildings, being close to high
    [Show full text]
  • Exposure for Vomiting Phobia
    Accepted Manuscript Title: Exposure Therapy for Emetophobia: A Case study with Three-Year Follow-Up Author: Danielle J. Maack Brett J. Deacon Mimi Zhao PII: S0887-6185(13)00133-3 DOI: http://dx.doi.org/doi:10.1016/j.janxdis.2013.07.001 Reference: ANXDIS 1522 To appear in: Journal of Anxiety Disorders Received date: 15-1-2013 Revised date: 12-5-2013 Accepted date: 8-7-2013 Please cite this article as: Maack, D. J., Deacon, B. J., & Zhao, M., Exposure Therapy for Emetophobia: A Case study with Three-Year Follow-Up, Journal of Anxiety Disorders (2013), http://dx.doi.org/10.1016/j.janxdis.2013.07.001 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Abstract Emetophobia, also referred to as a specific phobia of vomiting, is a largely under- researched and poorly understood disorder with prevalence estimates of ranging between 1.7 and 3.1% for men and 6 and 7% for women (Hunter & Antony, 2009; Philips, 1985). The current case study, therefore, sought to methodically apply exposure-based behavioral treatment to the treatment of a 26 year-old, Hispanic, female suffering from emetophobia. Although not as powerful as a randomized design, this description may still add to the existing emetophobia literature through the illustration of adaptation of published behavioral treatments for other specific phobias.
    [Show full text]
  • List of Phobias and Simple Cures.Pdf
    Phobia This article is about the clinical psychology. For other uses, see Phobia (disambiguation). A phobia (from the Greek: φόβος, Phóbos, meaning "fear" or "morbid fear") is, when used in the context of clinical psychology, a type of anxiety disorder, usually defined as a persistent fear of an object or situation in which the sufferer commits to great lengths in avoiding, typically disproportional to the actual danger posed, often being recognized as irrational. In the event the phobia cannot be avoided entirely the sufferer will endure the situation or object with marked distress and significant interference in social or occupational activities.[1] The terms distress and impairment as defined by the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV-TR) should also take into account the context of the sufferer's environment if attempting a diagnosis. The DSM-IV-TR states that if a phobic stimulus, whether it be an object or a social situation, is absent entirely in an environment - a diagnosis cannot be made. An example of this situation would be an individual who has a fear of mice (Suriphobia) but lives in an area devoid of mice. Even though the concept of mice causes marked distress and impairment within the individual, because the individual does not encounter mice in the environment no actual distress or impairment is ever experienced. Proximity and the degree to which escape from the phobic stimulus should also be considered. As the sufferer approaches a phobic stimulus, anxiety levels increase (e.g. as one gets closer to a snake, fear increases in ophidiophobia), and the degree to which escape of the phobic stimulus is limited and has the effect of varying the intensity of fear in instances such as riding an elevator (e.g.
    [Show full text]
  • A Guide to Phobias Rebrand
    A Guide to Phobias A phobia is strong fear or dread of a thing or event which is out of proportion to the reality of the situation. The most effective treatment is cognitive behaviour therapy (CBT). Antidepressant medication also helps in many cases. ©EMIS 2010, as distributed on http://www.patient.co.uk/health/ Phobias.htm Used with permission. A Guide to Phobias What are the symptoms of phobia? There are different types of phobia If you come near to, or in contact with, Social phobia the feared situation you become anxious Social phobia is possibly the most or distressed. In addition you may also common phobia. With social phobia you have one or more unpleasant physical become very anxious about what other symptoms. people may think of you, or how they may judge you. For example: a fast heart rate, palpitations, feeling sick, shaking Therefore, you fear meeting people, or (tremor), sweating, dry mouth, chest pain, ‘performing’ in front of other people, a ‘knot in the stomach’, fast breathing. especially strangers. You fear that you will The physical symptoms are partly caused act in an embarrassing or humiliating way, by the brain which sends lots of and that other people will think that you messages down nerves to various parts are stupid, inadequate, weak, foolish, of the body when you are anxious. In crazy, etc. You avoid such situations as addition, you release ‘stress’ hormones much as possible. (such as adrenaline) into the bloodstream when you are anxious. These can also Agoraphobia act on the heart, muscles and other parts This too is common.
    [Show full text]
  • Treatment of a Woman with Emetophobia: a Trauma Focused
    Mental Illness 2012; volume 4:e3 Treatment of a woman with with emetophobia, the avoidance response must be very distressing and have a significant Correspondence: Ad de Jongh, Department of emetophobia: a trauma focused impact on the person’s life. As a result, emeto - Behavioral Sciences, Academic Centre for approach phobics have a tendency to avoid a wide array Dentistry Amsterdam, Louwesweg 1, 1066 EA of situations or activities that they believe Amsterdam, The Netherlands. Ad de Jongh might increase the risk of vomiting. For exam - E-mail: [email protected] Department of Behavioral Sciences, ple, they may avoid crowded places from which they fear they cannot quickly escape in case of Key words: specific phobia, vomiting phobia, ACTA, University of Amsterdam and emetophobia, EMDR. nausea or vomiting, such as shops, boats, air - Vrije Universiteit Amsterdam, planes, concerts and hospitals. In addition, The Netherlands; Received for publication: 28 August 2011. they may not be able to go on holiday or travel School of Health Sciences, Revision received: 2 December 2011. on public transport, but the avoidance behavior Accepted for publication: 2 December 2011. Salford University, Manchester, UK could also pertain to avoiding adults or chil - dren who may be ill (and, therefore, regarded This work is licensed under a Creative Commons as contagious) or who are at risk of vomiting Attribution NonCommercial 3.0 License (CC BY- NC 3.0). (e.g. people who are drunk). The avoidance Abstract might extend to using public toilets or door ©Copyright
    [Show full text]
  • Toward a Conceptualization of Emetophobia: Examining Intolerance of Uncertainty As a Unique Predictor of Symptoms
    University of Mississippi eGrove Electronic Theses and Dissertations Graduate School 2014 Toward A Conceptualization Of Emetophobia: Examining Intolerance Of Uncertainty As A Unique Predictor Of Symptoms Mimi Zhao University of Mississippi Follow this and additional works at: https://egrove.olemiss.edu/etd Part of the Clinical Psychology Commons Recommended Citation Zhao, Mimi, "Toward A Conceptualization Of Emetophobia: Examining Intolerance Of Uncertainty As A Unique Predictor Of Symptoms" (2014). Electronic Theses and Dissertations. 814. https://egrove.olemiss.edu/etd/814 This Thesis is brought to you for free and open access by the Graduate School at eGrove. It has been accepted for inclusion in Electronic Theses and Dissertations by an authorized administrator of eGrove. For more information, please contact [email protected]. TOWARD A CONCEPTUALIZATION OF EMETOPHOBIA: EXAMINING INTOLERANCE OF UNCERTAINTY AS A UNIQUE PREDICTOR OF SYMPTOMS A Thesis presented in partial fulfillment of requirements for the degree of Master of Arts in the Department of Psychology The University of Mississippi by MIMI S. ZHAO August 2013 Copyright Mimi S. Zhao 2013 ALL RIGHTS RESERVED ABSTRACT Emetophobia, a poorly understood disorder, is a specific phobia characterized by an irrational and persistent fear of oneself vomiting or others vomiting. Though research on the disorder is sparse, previous investigations have reported interference in social, occupational, and health domains in the lives of individuals with emetophobia (Lipsitz et al., 2001; McFayden & Wyness, 1983; Veale & Lambrou, 2006). To this end, the current study examined whether individual differences in Anxiety Sensitivity (AS), Disgust Sensitivity (DS), and Intolerance of Uncertainty (IU) are associated with symptoms of emetophobia, whether AS predicts symptoms of emetophobia above and beyond DS, IU, and expected covariates of anxiety and depressive symptoms, and whether DS predicts symptoms of emetophobia above and beyond IU and expected covariates of anxiety and depressive symptoms.
    [Show full text]
  • How to Find a Therapist for Emetophobia Even If They Don’T Know What It Is
    How to Find a Therapist for Emetophobia Even if they don’t know what it is By Lori Riddle-Walker, EdD, MFT How to Find a Therapist for Emetophobia Emetophobia, also known as specific phobia of vomiting (SPOV), is a chronic, complex disorder that can have a severe impact on quality of life. Common avoidances such as staying away from children; refusing to attend social or family events where there is drinking; staying away from ill family members, fellow students or coworkers; avoiding public transportation; or avoiding starting a family due to the potential for morning sickness are examples of how emetophobia can interfere with relationships, work productivity, and overall life satisfaction. Disturbed eating to the point of significant weight loss or avoiding medical treatments that cause nausea or vomiting are some ways SPOV can even be life-threatening. Specific phobia of vomiting (emetophobia) has not been given significant attention by the research and treatment community. Many doctors and therapists are unfamiliar with emetophobia, leaving sufferers feeling misunderstood. We are trying to change that unfortunate reality. In the meantime, how can you get help? Symptoms of Emetophobia Emetophobia is a complex disorder with multiple symptoms that must be addressed for successful treatment. For example, sufferers often have traumatic memories from childhood, or other earlier experiences of vomiting, that become mentally intrusive flash-backs, especially in the face of vomiting triggers. Obsessional fear can also become intrusive, leading to catastrophizing or “what if” scenarios that are experienced as “flash forwards.” Cognitive processes that maintain fear are also common. These processes include certain thoughts, beliefs, or thinking patterns that keep fear in place by encouraging avoidance and limiting corrective experiences.
    [Show full text]
  • EMDR Therapy for Specific Fears and Phobias: the Phobia Protocol
    SPECIFIC PHOBIA EMDR Therapy for Specifi c Fears 1 and Phobias: The Phobia Protocol Ad de Jongh Introduction When a person starts to demonstrate an excessive and unreasonable fear of certain objects or situations that in reality are not dangerous, it is likely that the person fulfi ls the criteria for specifi c phobia as stated in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM-5; American Psychiatric Association, 2013). The main features of a spe- cifi c phobia are that the fear is elicited by a specifi c and limited set of stimuli (e.g., snakes, dogs, injections, etc.); that confrontation with these stimuli results in intense fear and avoidance behavior; and that the fear is “out of proportion” to the actual threat or danger the situation poses, after taking into account all the factors of the environment and situa- tion. Symptoms must also now have been present for at least 6 months for a diagnosis to be made of specifi c phobia. The DSM-5 distinguishes the following fi ve main categories or subtypes of specifi c phobia: • Animal type (phobias of spiders, insects, dogs, cats, rodents, snakes, birds, fi sh, etc.) • Natural environment type (phobias of heights, water, storms, etc.) • Situational type (phobias of enclosed spaces, driving, fl ying, elevators, bridges, etc.) • Blood, injury, injection type (phobias of getting an injection, seeing blood, watching surgery, etc.) • Other types (choking, vomiting, contracting an illness, etc.) Research Evidence suggests that with respect to the onset of phobias, particularly highly disruptive emotional reactions (i.e., helplessness) during an encounter with a threatening situation have the greatest potential risk of precipitating specifi c phobia (Oosterink, de Jongh, & Aartman, 2009).
    [Show full text]
  • Volume 55, Number 4 October-December 2013
    Volume 55, Number 4 October-December 2013 A TRIBUTE men in Goa – A population- based follow-up study Prof. J. K. Trivedi ABHIJIT NADKARNI, BHARGAV BHAT, SHAH EBRAHIM, ROY ABRAHAM KALLIVAYALIL, PRONOB KUMAR DALAL 311 VIKRAM PATEL 376 EDITORIAL CASE REPORTS Psychosomatic paradigms in psoriasis – Psoriasis, Body dysmorphic disorder – Borderline category stress and mental health between neurosis and psychosis T. S. SATHYANARAYANA RAO, K. H. BASAVARAJ, KEYA DAS 313 K. RAMAN 380 GUEST EDITORIALS Dothiepin-induced transient hypomania and extrapyramidal syndrome Sexual abuse in women with special reference to AMIR INAMDAR, ASHISH AGARWAL, PANKAJ KATARIA, children: Barriers, boundaries and beyond R. P. BENIWAL 383 P. B. BEHERE, T. S. SATHYANARAYANA RAO, AKSHATA N. MULMULE 316 A case of Hallervorden-Spatz disease presenting as catatonic schizophrenia Loneliness – A disease? YOGESH PAWAR, GURVINDER KALRA, SARVADA CHANDRA TIWARI 320 SUSHMA SONAVANE, NILESH SHAH 386 REVIEW ARTICLE Emetophobia – A fear of vomiting Group psychotherapies for depression in persons ABHIJEET D. FAYE, SUSHIL GAWANDE, RAHUL TADKE, with HIV – A systematic review VIVEK C. KIRPEKAR, SUDHIR H. BHAVE 390 ABHIJIT RAMANNA HONAGODU, MURALI KRISHNA, RAJESH SUNDARACHAR, PETER LEPPING 323 CME Forensic evaluations in psychiatry ORIGINAL ARTICLES R. K. CHADDA 393 Assessment of cognition in non-affected full ART & PSYCHIATRY biological siblings of patients with schizophrenia ROHIT GARG, J. K. TRIVEDI, P. K. DALAL, ANIL NISCHAL, Music and Mind P. K. SINHA, SANNIDHYA VARMA 331 SRAVANTI SANIVARAPU 400 Prevalence of Attention Deficit Hyperactivity VIEW POINT Disorder in primary school children The rise of super (?sub)-specialties courses in JYOTHSNA AKAM VENKATA, ANUJA S. PANICKER 338 psychiatry – Is India ready for it! N.
    [Show full text]
  • LIST of PHOBIAS Presented By: the Post Apocalyptic Forge Source
    LIST OF PHOBIAS Presented by: The Post Apocalyptic Forge Source: http://www.phobialist.com/index.html A- Ablutophobia- Fear of washing or bathing. Acarophobia- Fear of itching or of the insects that cause itching. Acerophobia- Fear of sourness. Achluophobia- Fear of darkness. Acousticophobia- Fear of noise. Acrophobia- Fear of heights. Aerophobia- Fear of drafts, air swallowing, or airbourne noxious substances. Aeroacrophobia- Fear of open high places. Aeronausiphobia- Fear of vomiting secondary to airsickness. Agateophobia- Fear of insanity. Agliophobia- Fear of pain. Agoraphobia- Fear of open spaces or of being in crowded, public places like markets. Fear of leaving a safe place. Agraphobia- Fear of sexual abuse. Agrizoophobia- Fear of wild animals. Agyrophobia- Fear of streets or crossing the street. Aichmophobia- Fear of needles or pointed objects. Ailurophobia- Fear of cats. Albuminurophobia- Fear of kidney disease. Alektorophobia- Fear of chickens. Algophobia- Fear of pain. Alliumphobia- Fear of garlic. Allodoxaphobia- Fear of opinions. Altophobia- Fear of heights. Amathophobia- Fear of dust. Amaxophobia- Fear of riding in a car. Ambulophobia- Fear of walking. Amnesiphobia- Fear of amnesia. Amychophobia- Fear of scratches or being scratched. Anablephobia- Fear of looking up. Ancraophobia- Fear of wind. (Anemophobia) Androphobia- Fear of men. Anemophobia- Fear of air drafts or wind.(Ancraophobia) Anginophobia- Fear of angina, choking or narrowness. Anglophobia- Fear of England or English culture, etc. Angrophobia - Fear of anger or of becoming angry. Ankylophobia- Fear of immobility of a joint. Anthrophobia or Anthophobia- Fear of flowers. Anthropophobia- Fear of people or society. Antlophobia- Fear of floods. Anuptaphobia- Fear of staying single. Apeirophobia- Fear of infinity. Aphenphosmphobia- Fear of being touched.
    [Show full text]
  • Emetophobia: Facing the Fear of Vomit
    Emetophobia: Facing the Fear of Vomit A Millen, M.S. & B Bergstrom, Psy.D. School of Professional Psychology College of Health Professions Emetophobia Emetophobia is defined as a fear of vomiting and has been cited as one of the least understood anxiety disorders. (Boschen, 2007; Maack, Deacon & Zhao, 2013; Marks, 1987) Emetophobia • Prevalence Rates 6-7% for women; 1.7-3.1% for men • Chronic Problem • Early Onset • Clinically Significant Distress & Impairment Limited available empirical research (Hunter & Antony, 2009; Philips, 1985) There is a lack of specific examination of the cognitive factors involved in fear of vomiting. Consequently, no incorporation of cognitive techniques into treatment packages specifically tailored for emetophobia (Hunter & Antony, 2009; Boschen, 2007) Preliminary Research Not a rare condition seen in clinical practice Overall, conceptualization in early stages (Maack, Deacon, & Zhao, 2013; Veale & Lambrou, 2006) Evidence-based Treatment (EBT) • Exposure-based interventions first-line treatments of choice (Powers & Deacon, 2013) • Substantial support for exposure therapy for many specific phobias Despite efficacy data, small minority of therapist actually deliver exposure therapy for anxiety (Becker, Zayfert, & Anderson, 2004; add all) Single Subject Case Study • “Victoria” • 30, single, self-referred • Presented initially to therapy with generalized anxiety • Later, shared a fear of vomit Etiological & Maintaining Factors “CBT Model” “Victoria” General predisposition to anxiety Generalized worry Somatization
    [Show full text]